Agenesis of the corpus callosum is associated with feeding difficulties

An observational report of swallowing outcomes following corpus callosotomy

AIM

Determine swallowing outcomes following corpus callosotomy (CC) surgery.

METHODS

Retrospective chart review of patients undergoing CC between July 2016 and November 2018 at a large, urban children's hospital.

RESULTS

Of the 18 patients without prior history of dysphagia who underwent CC, 15 received speech pathology consults for bedside swallowing evaluation (BSE). Four patients were referred for a videofluroscopic swallow study (VFSS), and 3 showed no signs of difficulty and were advanced to regular diets with thin liquids. One patient demonstrated swallowing difficulties during the VFSS and was placed on a regular diet with nectar thick liquids. Following a repeat swallow study 17 days post-surgery, the patient was advanced to thin liquids.

INTERPRETATION

Postoperative dysphagia following CC is an uncommon and transient complication. Patients undergoing CC should have their swallowing evaluated prior to advancing their postoperative diet but are likely to return to normal diet and thin liquids by discharge.

Social-emotional, sleep and feeding problems in young patients with agenesis of the corpus callosum and the life quality of their parents

Agenesis of the corpus callosum (ACC) is a common congenital brain malformation. Most patients with no combined abnormalities have a good prognosis, but impairments have been observed in their sleep, feeding, and higher-order cognitive functions. Sixty-three Chinese ACC patients, aged 0-3 years, were included in our cross-sectional online research. The Chinese version of Infant-Toddler Social and Emotional Assessment (ITESA), the Brief Infant Sleep Questionnaire (BISQ), and the Montreal Children's Hospital Feeding Scale (MCH-FS) were used to assess these patients. We also used the brief version of the World Health Organization's Quality of Life Instrument (WHOQOL-BREF) to evaluate their parents. 43% of patients had ITESA domain problem: 10% in Externalizing, 7% in Internalizing, 3% in Dysregulation, and 30% in Competence. 52% of the patients were rated by their parents as having a sleep problem. Feeding difficulties occurred in 23% of patients. Patients' sleep and feeding problems were significantly correlated with their social and emotional performance, which influenced the life quality of their parents. Patients with intracranial abnormalities had more internalizing problems. In conclusion, sleep and feeding problems in young ACC patients might indicate their social-emotional problems. The problems in ACC patients were correlated with the life quality of their parents.

Corpus callosum and epilepsies

Introduction.Corpus callosum (CC) is the largest forebrain commissure. Structural anomalies and accompanying clinical symptoms are not in the focus of neurologists, epileptologists or neurosurgeons.

Aim and method.Anatomy, embryological development, normal functions, structural abnormalities, additional malformations, clinical symptoms and seizure disorders with CC anomalies are reviewed from the literature.

Review.The detection of callosal anomalies increased rapidly with widespread use of brain imaging methods. Agenesis or dysgenesis of corpus callosum (AgCC) might be considered an accidental finding. Epileptic seizures occur in up to 89% of patients with AgCC. The causal relationship correctly is questioned. However, additional causative malformations of midline and/or telencephalic structures can be demonstrated in most seizure patients. The interruption of bilateral spread of seizure activities acts as the concept for callosotomy as epilepsy surgery. Indications are drug-resistant generalized, diffuse, or multifocal epilepsies. A resectable seizure onset zone should be excluded. Most treated patients are diagnosed as Lennox-Gastaut or Lennox-like syndrome.

Conclusions.In cases with callosal abnormalities and clinical symptoms additional malformations are frequently observed, especially with seizure disorders. Callosotomy is the most effective option against drop attacks. The method probably is underused. After callosotomy a circumscript seizure focus might be unveiled and a second step of resective epilepsy surgery can be successful.

Agenesis of the corpus callosum: classifying functional manifestations with the ICF-CY

PURPOSE

Agenesis of the corpus callosum (ACC) is a congenital condition in which the corpus callosum fails to develop fully. In the literature, ACC has been broadly conceptualized and inconsistently described. This article demonstrates how the universal language of the International Classification of Functioning, Disability and Health-Children and Youth can increase the specificity with which researchers and clinicians describe the variable manifestations of ACC.

METHODS

The database for this article was based on a review of 83 studies on developmental and neuropsychological manifestations of congenital ACC in children and adolescents. First, the extent to which the findings on ACC could be documented using the taxonomic codes in the ICF-CY was examined. Next, the findings from each study were mapped onto the ICF-CY to summarize the distribution of clinical features reported in the literature.

RESULTS

There was a high degree of correspondence between the reported findings and the taxonomic codes of the ICF-CY. The distribution of clinical features was discussed.

CONCLUSIONS

This taxonomic application advances the ICF-CY as a common language for researchers and clinicians who work with children who have ACC. Implications for Rehabilitation Agenesis of the corpus callosum (ACC) is a condition that has been broadly conceptualized and inconsistently described in research and practice. The variable clinical manifestations of children with ACC can be most effectively described using the ICF-CY. The application of the ICF-CY to conditions with highly variable clinical manifestations, like ACC, positively impacts research and practice.

Corpus callosum agenesis and rehabilitative treatment

Corpus callosum agenesis is a relatively common brain malformation. It can be isolated or included in a complex alteration of brain (or sometimes even whole body) morphology. It has been associated with a number of neuropsychiatric disorders, from subtle neuropsychological deficits to Pervasive Developmental Disorders.

Etiology and pathogenetic mechanisms have been better understood in recent years, due to the availability of more adequate animal models and the relevant progresses in developmental neurosciences. These recent findings are reviewed (through a MedLine search including papers published in the last 5 years and most relevant previously published papers) in view of the potential impact on children's global functioning and on the possible rehabilitative treatment, with an emphasis on the possibility to exploit brain plasticity and on the use of the ICF-CY framework.

Health-related issues in individuals with agenesis of the corpus callosum

OBJECTIVES

To explore and compare the prevalence and expression of specific health-related variables in a large survey sample of persons with agenesis of the corpus callosum (ACC) and their siblings.

METHODS

Caregiver surveys of individuals with ACC (n=189) and their siblings (n=189) provided data regarding diagnoses, physical features, neurological and sensory information, feeding, elimination and sleep concerns, and some behavioural features.

RESULTS

Compared with their siblings, individuals with ACC had more concurrent conditions and were more likely to have altered pain perception and sensitivity to touch. In addition, individuals with ACC had more sensory deficits and abnormalities as well as altered patterns of feeding/eating, elimination and sleep.

CONCLUSIONS

These data raise important questions for future research and suggest the need for increased vigilance by caregivers and health-care professionals of individuals with callosal disorders. Early detection and intervention may help prevent or ameliorate health problems in this population.

Characteristics, associations and outcome of partial agenesis of the corpus callosum in the fetus

OBJECTIVES

To report, in a population of fetuses diagnosed with partial agenesis of the corpus callosum (PACC), the sonographic characterization, incidence of cerebral, extracerebral and chromosomal anomalies, and outcome. In addition, in some of our cases a comparison was made between findings on ultrasound and fetal magnetic resonance imaging (MRI).

METHODS

This was a retrospective study of all cases of PACC seen at two referral centers for prenatal diagnosis of congenital anomalies over a 10-year period. The following variables were assessed: indication for referral, additional cerebral and extracerebral malformations, chromosomal abnormalities, and pregnancy and fetal/neonatal outcome.

RESULTS

Among 54 cases of fetal agenesis of the corpus callosum detected in the referral centers during the observation period, PACC was diagnosed at prenatal sonography in 20 cases and confirmed at pre/postnatal MRI and necropsy examinations in 19 cases (35%). These 19 constituted the study group. The diagnosis was made in the sagittal planes and in 12 cases it was made prior to 24 weeks. In most cases the indication for referral was the presence of indirect signs of callosal anomalies, such as colpocephaly. In 10 cases PACC occurred in association with other anomalies and in nine it was isolated. MRI was particularly useful for demonstrating some additional cerebral anomalies such as late sulcation, migrational pathological conditions and heterotopia. Regarding pregnancy outcome, of those diagnosed before 24 weeks which had associated anomalies, all except two were terminated. Of the nine cases with isolated PACC, all were liveborn. Follow-up was available in eight, and two of these (25%) showed evidence of significant developmental delay. In our series the outcome of isolated PACC was not better than that of complete agenesis of the corpus callosum reported in other series.

CONCLUSIONS

PACC can be diagnosed reliably and characterized in prenatal life. The sonographic sign present in most cases is colpocephaly. Prenatal MRI can be performed to confirm the diagnosis. It is particularly useful to demonstrate some additional cerebral anomalies such as late sulcation, migrational pathological conditions and heterotopia. The relatively poor survival rate is due to the high rate of terminations and associated major anomalies.